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NPI Code Detail

MEDICARE: VICENTE GAVIERES MD

MEDICARE: VICENTE GAVIERES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician30687KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457356131
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICENTE GAVIERES MD
Provider Business Mailing Address
First Line : 639 N MULBERRY ST
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-1931
Country : US
Telephone Number : 270-737-4600
Fax Number : 270-737-1722
Provider Business Practice Location Address
First Line : 639 N MULBERRY ST
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-1931
Country : US
Telephone Number : 270-737-4600
Fax Number : 270-737-1722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 03/19/2008

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Directions to “ VICENTE GAVIERES MD” Practice Location

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